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The Annals of Thoracic Surgery, Vol 56, 1063-1068, Copyright © 1993 by The Society of Thoracic Surgeons
MS Slaughter, MM Olson, JT Lee Jr and HB Ward
Wound infections after coronary artery bypass operations have been
continuously monitored at the Minneapolis Veterans Affairs Hospital for 15
years. All patients were followed up for 30 days. From 1977 to 1991, 2,402
coronary artery bypass operations were performed, and wound infections
developed in 125 (5%) patients. There were 71 (3%) chest infections of
which 33 (1.4%) were major and 38 (1.6%) superficial. Greater than 94% of
these grew only a single organism, of which 74% were Staphylococcus
species. There were 63 (2.6%) leg wound infections. More than 50% of these
grew multiple organisms, of which 68% were enteric in origin. Nine (0.4%)
patients had simultaneous chest and leg infections. Wound infections were
diagnosed an average of 15.3 +/- 6.7 (range, 4 to 30) days postoperatively,
with 50% occurring after discharge from the hospital. Of 14 variables
evaluated by multivariate logistic regression analysis, only steroids (p =
0.005) and diabetes (p = 0.003) were identified as independent risk factors
for wound infections. Patients taking steroids or with diabetes tended to
have chest infections, whereas obese patients tended to have more leg
infections (p = 0.08). During an interval in the surveillance program, a
trend toward increasing infections was identified and successfully
reversed.
ARTICLES
A fifteen-year wound surveillance study after coronary artery bypass
Department of Surgery, Minneapolis Veterans Affairs Medical Center, MN 55417.
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